1558615393 NPI number — EMPRESAS FIGUEROA-GOYTIA Y SONYA GOYTIA

Table of content: (NPI 1558615393)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558615393 NPI number — EMPRESAS FIGUEROA-GOYTIA Y SONYA GOYTIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMPRESAS FIGUEROA-GOYTIA Y SONYA GOYTIA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558615393
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BOX 1468 TRUJILLO ALTO
Provider Second Line Business Mailing Address:
CALLE LA CRUZ 307 TRUJILLO ALTO
Provider Business Mailing Address City Name:
TRUJILLO ALTO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00976
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-760-5179
Provider Business Mailing Address Fax Number:
787-760-4500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE LA CRUZ 307
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRUJILLO ALTO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00977-1468
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-760-5179
Provider Business Practice Location Address Fax Number:
787-760-4500
Provider Enumeration Date:
11/01/2012

Additional Information

Authorized Official

Authorized Official Last Name:
GOYTIA
Authorized Official First Name:
SONYA
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
LABORATORY DIRECTOR
Authorized Official Telephone Number:
787-760-5179

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  556 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 40D0658219 . This is a "CLIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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